Individual
LEA GOSSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
296 TALATHA CHURCH RD, AIKEN, SC 29803-9649
(803) 257-1193
Mailing address
5950 RIVER RUSH CT, SUGAR HILL, GA 30518-7457
(803) 257-1193
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003739
GA
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/26/2016
Last updated
03/02/2020
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